Purpose of Award: To support a study of the health literacy barriers to navigating the health care system faced by Monterey County’s diverse and low-income population.
Principle Investigator: Jerry Endres M.S.W. Director, Institute for Community Collaborative Studies (1995-2008), California State University Monterey Bay
Functional health literacy means the patient must be able to ask questions to be informed about their medical condition. Health literacy is about accessing medical information, communication and understanding, and taking health-related action, so much more than just having the ability to read medical information.
Our survey study, commissioned by the Health Literacy Coalition serving the California tri-county areas of Monterey, San Benito and Santa Cruz counties and funded by the California Endowment was conducted from July 2004 to May 2005. A total of 198 survey respondents were identified with the assistance of the following community organizations who are members of the Health Literacy Coalition:
Recent studies have uncovered the connections between literacy levels and health status and have found extensive evidence that low literacy and poor health outcomes areinextricably linked. In conducting a survey in Monterey County, California, weidentified findings that health literacy improves when individuals are enrolled in a health-related education or treatment program are compared with individuals enrolled in a (literacy) education program only. In our survey of predominantly Mexican-American and low-income respondents, we asked them to respond to questions about health status, access to health services, health literacy and cultural competency issues related to obtaining quality healthcare across the continuum of medical services.
The three study groups (WIC, Clinica and Adult School), we believe, are representative of both low-income Mexican-American families and other low-income, diverse populations across Monterey County. The WIC and Adult School respondents are located in the greater Salinas geographical area. The Clinica respondents were interviewed in the Castroville, Chular and Gonzales areas representing north and south Monterey County. The data is presented by combining the WIC and Clinica responses because these respondents were interviewed as individuals while the Adult School respondents completed the survey in a classroom setting resulting in a greater percentage of “no responses” to questions. Additionally the aggregated data findings are very similar for WIC and Clinica vs. the differences found with the Adult School respondents who are not enrolled in a health related program.
Finding: Strengthening Individual Consumer Knowledge and Skills
The individuals enrolled in the health-related programs had experiences that provided health information resulting in fewer literacy barriers, a better understanding of health education materials and health-related signage, even their own health insurance policy.
The individuals enrolled in the health-related programs were better able to use their language of origin to make appointments and talk with their doctor, to use an interpreter and converse with bilingual staff in their physician’s office.
The individuals enrolled in the health-related programs more often reported their doctor explained what their family needs to know and answers all their questions resulting in a better understanding of their doctor’s orders.
Finding: Access to Health Services
Individuals enrolled in the health-related programs utilize clinics rather than emergency room services for all conditions and were more likely to see a doctor than to use an alternative remedy.
Individuals enrolled in the health-related programs had a greater knowledge of community resources and more often were able to afford adequate health insurance.
Finding: Health Status Issues
Individuals enrolled in the health-related programs were freer from illness, had less untreated medical conditions and were managing health issues more adequately; even with family members having had a greater amount of severe pain in the last month period.
Individuals enrolled in the health-related programs were better able to get medical care when needed with a greater likelihood of health treatments meeting their needs.
Finding: Satisfaction with Health Providers
Individuals enrolled in the health-related programs reported greater interest, respect, and openness to the patient’s viewpoint leading to their greater satisfaction in how the doctor treats them as a person.
Individuals enrolled in the health-related programs also report greater trust in their doctor leading to following their advice and satisfaction in the quality of care.
Finding: Medication Compliance
Individuals enrolled in the health-related programs reported greater understanding of the side effects associated with the medications their doctor prescribes.
Individuals enrolled in the health-related programs are more likely to have a regular pharmacy and know how to pay for medications.
Finding: Referrals to Specialists and Labs
Individuals enrolled in the health-related programs are more likely to understand why they are referred to labs and specialists, understand treatments and procedures, follow directions after the visit and know how to pay for services.
Access and Communication with Health Care Providers